Anesthesia Coding Alert

Get the timing right and the best person in place for the job.

It’s not unusual for a practice to fall behind on reconciling their accounts receivable (A/R), especially when there always seem to be more pressing issues at hand. Yes, the A/R work will always be there when you turn back to it – but don’t let it wait too long.

Here’s why: By the time you get time to address the issue, you could be looking at a mountain of backlogged A/R, and staring at a balance sheet that is askew due to the uncollected money the practice has sitting in limbo.

If you’re behind on your A/R, use this expert advice to catch up, and get the practice’s books back to a state of balance.

Prep Charts Before Seeing Patients

For practices that are behind on A/R, Leah Paraschiv, CMPE, client manager and reimbursement expert at MSOC Health in Chapel Hill, N.C., recommends that you do chart prep a day or two before each patient’s scheduled appointment.

Performing chart prep that early might take some extra planning, but it will give you “adequate time to review past due balances and any insurance denials that require the patient’s assistance to resolve,” Paraschiv says.

Once you have performed the chart prep, the practice must be ready to “collect money or any needed information when the patient presents for check-in,” Paraschiv explains. The best time to reconcile a patient’s A/R is “when the patient is in your practice seeking further treatment; once they make it out your door, they lose all incentive to comply,” she says.

As a preemptive strike against long-term A/R headaches, Paraschiv recommends implementing a credit-card-on-file program, “so that any future balances can be collected as soon as you receive the insurance response; this is the best way to ensure that patient A/R does not continue to grow.”

Schedule Times for Regular A/R Review

In addition to getting chart preps done ahead of time, the practice administrator should conduct a semi-annual or annual review of the practice’s A/R, recommends Lauren Ballew, MHA, CMPE, director of operations at MSOC Health in Chapel Hill, N.C.

Ballew concedes this is a tedious task, but you owe it to the practice to make sure your A/R lines up with insurance company totals. During these reviews, however, you might discover A/R anomalies with certain payers, such as:

• demographics entry issues
• differences in claim requirements among different insurers
• potential administrative glitches causing A/R issues.

In order to reach maximum effectiveness, a practice administrator should perform these A/R reviews. You might have other staff work the line items on an A/R report, but after that, you’ll need someone high enough up that they can make policy decisions based on how the A/R issues connect with the rest of the practice’s concerns.

“You need a leader with the ability to implement across-the-board improvements [that] must have an understanding of what’s working and what’s not,” Ballew explains. Once you get that leader’s A/R analysis, you can “strategize to solve the A/R problems once and for all.”